title: Biomechanical analysis of the effect of intracranial pressure on the orbital distances in trigonocephaly.
abstract: OBJECTIVE
  This biomechanical study aims to elucidate differences in how skulls with trigonocephaly, normal skulls, and postoperative trigonocephalic skulls respond to intracranial pressure and how this affects the orbital distances.
  
  
  METHODS
  For 10 patients with trigonocephaly (8.2 ± 4.5 months), simulation models were produced based on the computed tomographic data of the skulls. These models were categorized as the Trigono group. For each model, a 15-mm Hg pressure was applied to the neurocranium to simulate the intracranial pressure. The interorbital distances expanded in response to the applied pressure. The amount of the change in the orbital distance was calculated using finite element analysis. The same processes were repeated for 10 models simulating normal skulls (the Control group) and postoperative trigonocephalic skulls (the Remodeled group). The changes in the orbital distance were compared among the three groups.
  
  
  RESULTS
  The changes in the orbital distance were significantly smaller for the Trigono group than for the Control group. However, changes were significantly greater for the Remodeled group than for the Control group.
  
  
  CONCLUSIONS
  The expansion of interorbital distances in response to the cranial pressure is restricted in skulls with trigonocephaly. This restriction is eliminated by performing remodeling of the skull. These findings explain why spontaneous correction of hypotelorism occurs postoperatively in trigonocephaly.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagasao
authors.forename: Junpei
authors.initials: J
authors.lastname: Miyamoto
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kaneko
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Tamaki
mesh_terms: D001696:Biomechanical Phenomena; D003198:Computer Simulation; D003398:Craniosynostoses / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D009915:Orbit / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed